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Controversy Over Paper on Chemosensitivity Testing

Controversy Over Paper on Chemosensitivity Testing

July 01, 2002

In December 2000, ONCOLOGY’s Jim
McCarthy sent me a letter, inviting me to prepare an article for the journal on
"The Current Status of Chemotherapy Sensitivity Assays." I was
informed that the paper would be referred to one or two reviewers, who would
write a commentary to be published alongside the paper. The commentary, I was
told, might be "entirely laudatory, highly critical, or somewhere in
between," and the result, "both lively and informative."

I prepared and submitted the article, but more than 4 months
later, I received a terse notice that it would not be published. This led to an
exchange of correspondence and a reaffirmation of ONCOLOGY’s decision not to
publish the paper.

In an era of ever-increasing numbers of partially effective
cancer therapeutics, there is an obvious need for technologies to better match
treatment to patient. The field of chemotherapy sensitivity assays has been
controversial, but there is a substantial literature that has not been recently
reviewed and with which the vast majority of clinical oncologists are not
familiar.

Approximately 10,000 individual patient specimens are currently
being submitted for testing by more than 1,000 clinical oncologists, surgeons,
and pathologists annually in the United States. Not infrequently, the tests
engender uninformed reactions and opinions from various clinicians within the
referring medical centers.

In short, this is a timely and important topic for review,
consideration, and debate. However, my manuscript was rejected with an initial
explanation stating only that "the subject is just too controversial."

D.F. Horrobin published a commentary[1] on the peer review
process, which is relevant to situations such as this. He states:

Peer review can be performed successfully only if those
involved have a clear idea as to its fundamental purpose. Most authors of
articles on the subject assume that the purpose of peer review is quality
control. This is an inadequate answer.... Peer review must therefore aim to
facilitate the introduction into medicine of improved ways of curing,
relieving, and comforting patients. The fulfillment of this aim requires both
quality control and the encouragement of innovation. If an appropriate balance
between the two is lost, then peer review will fail to fulfill its purpose.

I believe that I succeeded in preparing a complete and
up-to-date review of an important and poorly understood topic. The complete text
of this review as originally submitted, along with the verbatim comments of the
single reviewer, and all correspondence between ONCOLOGY and me are
available to interested readers on the following website: www.weisenthal.org

ONCOLOGY Responds

Dr. Weisenthal’s paper was submitted to
our editorial reviewers, and the consensus recommendation was to decline
publication. Dr. Weisenthal was provided, anonymously, with the full text of one
of the peer reviewer’s lengthy comments as well as the essence of other
reviewers’ recommendations, the consensus of which is that, in their opinion,
the science just doesn’t support the clinical recommendations in his paper.